Coronary Circulation; Conduction System of the Heart PDF

Coronary Circulation Conduction System of Heart Professor Jason Ivanusic Room E724 7th Floor, East Wing, Medical Building Email: [email protected] Phone: 83447254  WARNING This material has been provided to you pursu...

Coronary Circulation Conduction System of Heart Professor Jason Ivanusic Room E724 7th Floor, East Wing, Medical Building Email: [email protected] Phone: 83447254  WARNING This material has been provided to you pursuant to section 49 of the Copyright Act 1968 (the Act) for the purposes of research or study. The contents of the material may be subject to copyright protection under the Act. Further dealings by you with this material may be a copyright infringement. To determine whether such a communication would be an infringement, it is necessary to have regard to the criteria set out in Part 3, Division 3 of the Act.  AV Nodal branch SA Nodal branch Left coronary artery Circumflex branch Right coronary artery Left marginal branch Anterior interventricular branch Arterial supply of Right marginal Posterior interventricular heart artery branch Author’s own Right Coronary Left Coronary Artery Artery (dominant: crosses over IV septum, Left atrium gives off posterior Left ventricle interventricular) (most) Some right Right atrium ventricle Right ventricle SA node (45%) (most) AV node (10%) Diaphragmatic Interventricular surface of left septum ventricle AV bundle SA node (55%) AV node (90%) Anatomedia  AV Nodal branch SA Nodal branch Left coronary artery Circumflex branch Right coronary artery Left marginal branch Anterior interventricular branch Coronary arteries are “functional” end arteries Anastamoses Only effective in slow Right Posterior occlusions marginal interventricular artery branch Sudden occlusions cause Author’s own myocardial infarct Coronary heart disease Blockages in coronary arteries Prevent oxygen reaching cardiac muscle Tissue death results in pain and ineffective pumping of blood http://www.pennhealth.com/ency/presentations/100190_2.htm Angiography http://health.allrefer.com/health/angioplasty-coronary-artery- http://health.allrefer.com/health/angioplasty-cardiac-catheterization.html balloon-angioplasty-series-4.html Angioplasty http://health.allrefer.com/health/angioplasty-coronary-artery-balloon-angioplasty-series-5.html  Coronary bypass surgery http://www.pennhealth.com/ency/presentations/100190_4.htm  Triple Bypass http://www.pennhealth.com/ency/presentations/100190_5.htm  Venous RA drained by cardiac veins drainage of heart Oblique vein of left atrium Great cardiac vein Coronary sinus Left marginal vein Opening into Left posterior ventricular vein right atrium Middle cardiac vein Small cardiac vein Author’s own  Opening of Coronary sinus Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. New Jersey, Icon Learning Systems, 2003, ISBN: 1-929007- 15-9, Plate #208A Conduction system Atrioventricular bundle (bundle of His) Left bundle branch Sino Atrial Right bundle branch Node Moderator band Intrinsic (septomarginal trabecula) pacemaker ~70 beats/min Purkinje fibres Anterior papillary Atrioventricular node muscle (Can also pace by itself) Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. New Jersey, Icon Learning Systems, 2003, ISBN: 1-929007-15-9, Plate #213A Left bundle branch Netter, F.H. Interactive Atlas of Human Anatomy. 3rd ed. New Jersey, Icon Learning Systems, 2003, ISBN: 1-929007-15-9, Plate #213A Heart block If blockage occurs in branch of coronary vessels supplying SA node or AV node, then specialized cells in each of the nodes may die and the cardiac muscle will beat out of sync. Damage to AV node results in heart block, because SA activity can no longer reach the ventricles Pacemaker implanted to electrically stimulate ventricular cardiac muscle directly http://www.mayoclinic.com/health/pacemakers/HQ01165